Cape Town - No holidays, "hectic exhaustion", and 05:30 starts - this was life for the team working at the National Institute for Communicable Diseases (NICD) as they struggled to find the source of the deadly listeriosis outbreak.

"At many stages we were despairing," said Dr Juno Thomas, head of the NICD's Centre for Enteric Diseases, as a massive recall of Enterprise Foods meat products got under way on Monday.

"I'm really glad, and proud," said Thomas, after the NICD managed to crack which strain it was and where it originated.

The Department of Health announced on Sunday that, thanks to the efforts of a massive team of experts and support staff, the source of the listeriosis outbreak strain, known as ST6, was finally located and confirmed to be from an Enterprise Foods production facility in Polokwane.

According to the department, there were 948 laboratory cases of listeriosis recorded from January 2017, with 180 deaths.

Fatal bacteria

The breakthrough, which also led to the closure of the plant, has provided an opportunity to halt the spread of the potentially fatal bacteria.

According to the department, preliminary results also showed that several ready-to-eat processed meat products from the Enterprise facility located in Germiston contained Listeria monocytogenes (a type of bacteria), but the sequence type is not known yet.

It was discovered that 93 (85%) had eaten ready-to-eat processed meat products, mainly polony, followed by viennas, sausages and other "cold meat".

On Friday, January 12, nine children under the age of 5, from a crèche in Soweto, Johannesburg, were taken to the Chris Hani-Baragwanath Hospital and a paediatrician suspected a foodborne disease, possibly listeriosis.

Environmental health practitioners were informed and visited the crèche and took samples from two polony brands manufactured by Enterprise and Rainbow Chicken Limited, and from the stool of one of the ill children.

'End is in sight'

Thomas said that samples taken from the crèche and sent for analysis, gave them the breakthrough that they were working so hard for.

The team at the NICD alone included laboratory technicians, scientists, data clerks, assistants seconded from the virology department, people in the sequencing unit, and people who work in the emergency operations centre.

"Our laboratory staff worked extra hard. People gave up their December leave to come in," continued Thomas.

"We've been working weekends. Last weekend, staff were in at 05:30 to get everything going."

"But we are really relieved. At least now the end is in sight."

"We have been chasing every possible lead, going down a lot of rabbit holes, [and there were] a lot of red herrings," Thomas said.

But once they had the information about the children at the crèche in Soweto, they worked from there to find out where the food came from to narrow things down.

The team also included the World Health Organisation's technical experts and the health and agriculture departments.

Thomas said that while the NICD team was working on the listeriosis outbreak, they had to keep up with all other notifiable diseases, such as cholera.

Mushal Ali, an NICD Bioinformatitian (they use computer technology to analyse biological information), had postponed his planned holiday to Sudan in December to help solve the listeriosis crisis.

Unable to put the visit off any longer, he boarded a plane on Saturday morning and, when he landed, instead of starting his holiday, he checked back in to the work WhatsApp group, fired up his computer and continued working, staying in touch via email.

Ali analysed the entire genetic and DNA sequence of the whole bacteria, to determine which strain it was.

"I was waiting at home on Saturday night," said Thomas.

At 00:00 Ali let her know that the strain of listeriosis had been identified, and the source confirmed.

"Then we immediately informed the minister," said Thomas.

"It was exhausting, it was hectic."

However, she warned that the worst was not over yet.

Product recall

The product recall might take time to reach very remote areas and symptoms do not always show immediately. So, there is still a likelihood of more cases being reported.

Department of Health spokesperson Popo Maja said the department's priority was to get the products off the shelves, so they have not yet determined the scale of the operation.

The department has not pronounced yet on what the companies must do with the recalled products, because it is not sure if it has the legal authority to do so.

"The companies will have to find ways and means of dealing with the product."

On Monday, Tiger Brands said that although it detected low levels of listeriosis at its food-manufacturing plant, it denied any current direct links between the deaths of 180 people from the foodborne outbreak.

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